U.S. turns corner in war on cancer

Nationwide, annual deaths are falling, but rising obesity may doom that trend.

January 18, 2007

U.S. cancer deaths have fallen for a second consecutive year -- a hopeful sign that Americans are making gains against a major killer.

About 3,000 fewer people died from the disease in 2004 compared with the previous year, according to a report Wednesday from the American Cancer Society. The decrease builds on a smaller -- but landmark -- drop from 2002 to 2003.

Before then, cancer deaths had climbed annually since 1930.

Yet more than 553,000 Americans still succumbed to the disease in 2004, and doctors say ongoing improvements are needed in detection and treatment before cancer can be knocked from its place as the nation's second-leading cause of death.

"We are very pleased to see a decrease for the second year in a row, but we still have a huge cancer burden in this country," said Dr. Clarence Brown, president and chief executive officer of M.D. Anderson Cancer Center Orlando. "We haven't solved the problem yet."

The new data were compiled by the National Center for Health Statistics, which examined death certificates to determine cancer-related fatalities.

The analysis shows that the initial drop from 2002 to 2003 was slight, at 369 fewer cancer deaths. But the latest data yielded a more dramatic reduction, from 556,902 cancer deaths in 2003 to 553,888 in 2004.

"This second consecutive drop in the number of actual cancer deaths -- much steeper than the first -- shows last year's historic drop was no fluke," said John R. Seffrin, the society's chief executive officer, in a statement.

Doctors are attributing the improvement to a decrease in the number of smokers, more-effective treatments and widespread screenings such as colonoscopies.

The latest figures are encouraging to 63-year-old Pat Sakowicz of Orlando, who beat breast cancer 17 years ago and more recently fended off a precancerous skin lesion.

She still recalls the moment in 1990 when a doctor told her the lump in her breast was cancerous. More than 1.4 million Americans will learn they have cancer this year.

"It's an absolutely shocking feeling because you always think it can't happen to you," said Sakowicz, who volunteers for the American Cancer Society. "Your immediate reaction is they must have made a mistake. But then you step back and say, `I can either let this control me or I'm going to control it,' and you do what you have to do."

Sakowicz is among an estimated 10 million cancer survivors in the United States -- an army of former patients who are contributing to the reduction in deaths in their own way, said Dr. John Langdon with the Florida Hospital Cancer Center in Orlando.

Cancer survivors often push family members and friends to get routine screenings and serve as reminders that cancer can be cured, he said.

Continued advancements in detection, including the ability to gauge people's risk by studying their genes, could help doctors find the disease at early stages that are most treatable. However, some cancers remain difficult to detect and treat, Langdon said.

Lung cancer remains the biggest cancer killer for both men and women, and 160,000 people are expected to die from the disease this year, according to American Cancer Society projections. Though less common, other cancers such as pancreatic and ovarian remain highly deadly.

"There are types of cancer where there is much more hope than there has ever been -- breast and prostate come to mind," Langdon said. "But then, some of these cancers are not really under control at all."

In addition, the report points out, blacks are much more likely than any other group to develop cancer and die from it.

Though the reduction in total deaths is new, the nation's death rate from cancer has been on a gradual slide for the past decade. The rate -- the number of cancer-related deaths per 100,000 people -- has dropped about 1 percentage point a year in that time.

But the number of cancer deaths continued to rise because of overall growth in the population and the rising ranks of older people, who are more likely to develop the disease. It was only in 2003 and 2004 when the death rate fell more sharply, by about 2 percentage points, that a corresponding drop in actual deaths could be tallied.

But some doctors worry that the trend won't last.

Brown, at M.D. Anderson, said the growing obesity crisis may undermine any gains. Being overweight is associated with breast, ovarian, gastric and other cancers.

"We may see this entire pendulum begin to swing in the opposite direction," Brown said.